1.Lumbosacral Distraction Spondylodesis of Spondylolisthesis and Spondylolysis of L5
Jae Do KANG ; Pil Seong HA ; Kwang Yul KIM
The Journal of the Korean Orthopaedic Association 1987;22(2):515-524
Recently spondylolysis and spondylolisthesis have become major causes of low back pain in the orthopaedic field and numerous methods have been designed for its treatment. The authors used the LSDS with posterolateral fusion for 12 cases of spondylolisthesis and spondylolysis having low back pain and tenderness, which were operated on during the 4 years from Jan. 1983 to Jan. 1986 at Wallace Memorial Baptist Hospital. The advantages of LSDS with posterolateral fusion are as follows. l. In the case of distraction spondylodesis of interspinous process between L4 and Sl; A. the diameter of intervertebral formaina as well as of the whole spinal canal is widened. B. decompression is accomplished. C. the mechanical stress on the posterior columns of vertebral arch is lessened because the plumb line is anteriorly transferred. 2. Technique of LSDS; the knee-elbow position has the advantages of maximal kyphosis together with expansion of the space between the vertebral arches, as well as a reduction in the tendency to bleed because the blood collects in the abdominal vessels. 3. Internal fixation of grafted bone is not necessary. 4. A large surface area for unit mass of graft is in contact with blood supply. 5. Hypertrophy or displacement of graft can not encroach upon the epidural space; as may occur in certain circumstances following posterior fusion. The results of treatment are follows; l. In the case of improvement of symptoms after facet infiltration and knee-elbow position, satisfa- ctory results after LSDS were obtained. 2. The progression of slipping was not occurred after LSDS. 3. In increased lumbar lordosis, we have noted the instability especially with the changes from the mean values in Fergusons angles. 4. In the slip angle, there is some tendency to the lumbosacral instability correlating with the in- crease in the body weight. 5. We have also noted that the functional result was not closely related with degree of displacement.
Animals
;
Body Weight
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Decompression
;
Epidural Space
;
Hypertrophy
;
Kyphosis
;
Lordosis
;
Low Back Pain
;
Lysergic Acid Diethylamide
;
Protestantism
;
Spinal Canal
;
Spinal Fusion
;
Spondylolisthesis
;
Spondylolysis
;
Stress, Mechanical
;
Transplants
2.Reapir of the Torn Achilles Tendon, Using the Plantaris Tendon
Jae Do KANG ; Man Ku YOU ; Hong Jae YOO ; Pil Seong HA
The Journal of the Korean Orthopaedic Association 1985;20(5):961-966
A major problem in the repair of the torn Achilles tendon has been providing the restoration of the anatomic continuity such that virtually normal plantar flexion power and ankle mobility result. Continuity should be restored without subsequent pain, disconfiguration, occupational limitations. If possible, postoperative complications, or tendon-rerupture should be avoided. Surgeons have long advocated the use of strips of facia and other tissues, including the plantaris tendon, to reinforce the repair of the torn Achilles tendon, The repair effected by these methods not infrequently is bulky and not too secure. Non-absorbable suture materials utilizing in the end to end anastomosis of the torn Achilles tendon cause sinus formation and discharge of suture materials. A secure method of repair for the tom Achilles tendon, which decreases sinus formation and is not bulky, should be required. The plantaris tendon, which has been used as a reinforcing material, can be utilized in the end-to-end anastomosis of the torn Achilles tendon by detaching from the muculotendinous junction. The 11 patients with the torn Achilles tendon were treated by end-to-end anastomosis using the plantaris tendon as suture material. The postoperative results were staisfactory without significant functional deficit and complication.
Achilles Tendon
;
Ankle
;
Humans
;
Methods
;
Postoperative Complications
;
Surgeons
;
Sutures
;
Tendons
3.The Morphologic Study of the Calcar Femorale and its Relations to the Anteversion of the Neck of the Femur
Seung Won LEE ; Pil Seong HA ; Jae Do KANG ; Jin Jeong KIM
The Journal of the Korean Orthopaedic Association 1987;22(2):331-338
The calcar femorale is a specific anatomic entity which is often confused with the medial trabecular system or posteromedial cortex of the neck of the femur. The clinical significance of its architecture is evident when one considers the great number of operative procerdures performed in the upper end of the femur. This study deals with 45 cases of the Korean Dry femur(male: 27, female: 12, useless: 6) and two pairs of the femur from the cadavers. The authors observed the three dimensional structure of the calcar femorale and studied the relation between anteversion and calcar femorale. The results obtained were as follows: 1. The calcar femorale was a vertical plate of the thickened bone that lay deep to the lesser trochanter. The length in the vertical axis of the calcar femorale was 44.82±3.59mm. The calcar femorale was thickest medially where it joins the medial trabecular system of the femoral neck (maximal thickness: 2.65±0.65, width: 8.90±1.82mm). 2. The calcar femorale lay in one plane, which inclined 30.02±7.80 degree to the discondylar axis of the femur. By using this inclination of the calcar plane, it could be best visualized with about 60° external rotation of femur in a simple X-ray. 3. The angle between the calcar plane and the diacondylar axis was proportionate to the anteversion of the femoral neck. Correlation coefficient(r=0.80) was calculated. The regression line of y (anteversion) on x(calcar angle) was y=0.75X−8.53(slope). With this proportion, the angle of the femoral anteversion could be determined. 4. Microscopic features of the calcar femorale was revealed in the scanning electron microscopic studies. The medial side of the calcar was a cortical extension and it became thinner posterolaterally and than it was composed of fused or thickened trabeculae.
Cadaver
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Female
;
Femur Neck
;
Femur
;
Humans
;
Neck
4.Treatment of Complete Acromioclavicular Separation by Coracoclavicular Wiring
Jae Do KANG ; Pil Seong HA ; Jun Hee LEE ; Yang Hun LEE
The Journal of the Korean Orthopaedic Association 1988;23(2):535-541
Acromioclavicular joint injuries are frequently seen with the recent increase of traffic and industrial accidents. The treatment of complete separation of the acromioclavicular joint has been, and is still, a subject of controversy. In view of a recent trend, anatomical reduction of acromioclavicular joint, and rigid internal fixation method is preferable, especially in type 3 injury. We operated on 16 cases of complete acromioclavicular separation by the technique of coracoclavicular wiring from March 1983 to Feb. 1987. The following results were obtained. 1. The functional results were excellent; 12 cases(75%), good; 3 cases(19a%), and fair ; 1 cases(6%). 2. The complications include wire reakage ; 1 case(6%), bony erosion ; 3 cases(19%) and subluxation, 1 case(6%). 3. The advantages of coracoclavicular wiring. 1) Avoids violation of acromioclavicular joint but does not restrict rotation of the clavicle. 2) The operation is simple to perform. 3) Postoperative immobilization is minimal. 4) Removal of the wire is easy under local anesthesia. 5) This method corresponds to the coracoclavicular ligment biomechanically. Therefore, coracoclavicular wiring is thought to be a good operative method in the treatment of complete acromioclavicular separation.
Accidents, Occupational
;
Acromioclavicular Joint
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Anesthesia, Local
;
Clavicle
;
Immobilization
;
Methods
5.Knee Ligament Injuries Combined with Tibial Condyle Fracture: Clinical Study of 30 Patients
Shin Ho CHANG ; Jae Do KANG ; Pil Seong HA ; Jun Hee LEE
The Journal of the Korean Orthopaedic Association 1988;23(3):722-732
Injuries to the ligament, bone and other supporting structures of the knee joint have a tendency to increase becsuse of the increasing traffics, popularity of sports and industrial accidents. It is well known that the knee joint is burdened on motion and weight bearing and structurally it is more frequently injuried than other joints. When there is injury to the knee, it is frequently combined with injury to ligaments and other supporting structures rather than pure tibial condyle fracture. There remains a residual instability of the knee joint because of neglecting of the injured ligaments if treatment is concerned only with tibial condyle fracture. To obtain complete recovery from the injury, early diagnosis, prompt treatment and well planned exercise are important. Thirty patients with ligaments injury and tibial condyle fracture who were treated at the Depsrtment of Orthopaedic Surgery of Wallace Memorial Baptist Hospital from 1983 to 1987 have been reviewed. Through combined operative and conservative treatment, excellant and good results were obtained in 93% of the cases.
Accidents, Occupational
;
Clinical Study
;
Early Diagnosis
;
Humans
;
Joints
;
Knee Joint
;
Knee
;
Ligaments
;
Protestantism
;
Sports
;
Weight-Bearing
6.Treatment of the Fracture of the Middle Third of Clavicle by Intramedullary Threaded Steinmann Pin Fixation
Jae Do KANG ; Pil Seong HA ; Kwang Yul KIM ; Young Jin GWON
The Journal of the Korean Orthopaedic Association 1989;24(3):811-816
Clavicle fractures are frequently seen with the recent increase in traffic and industrial accidents. Recently, in adults, open reduction and internal fixation techniques are commonly performed for the patient to return earlier to their jobs. But internsl fixation technique for clavicle fractures has been a subject of controversy. We operated on 78 cases of fractures of the middle third of clavicle by the technique of intramedullary threaded Steinmann pin fixation from March 1985 to Nov. 1988. The following results were obtained. 1. The funtional results were excellent; 32 cases(41%), good; 41 cases(53%), fair ; 5 cases (6%). 2. The complications include motion limitation ; 5 cases(6%), pin tract infection ; 5 cases (6%), delayed union ; 1 case(1%) 3. The advantages of intramedullary threaded Steinmann pim fixation are as follows. 1) Early active range of motion is possible. 2) The operation procedure is simple to perform. 3) Removal of the pin is easy without anesthesia. Therefore, intramedullary threaded Steinmann pin fixation is thought to be a good operative technique for the clavicle fracture.
Accidents, Occupational
;
Adult
;
Anesthesia
;
Clavicle
;
Humans
;
Range of Motion, Articular
7.Quality of Life in Patients with Osteoporotic Vertebral Fractures.
Sang Pil YOON ; Seung Hwan LEE ; Chul Hyun KI ; Young Tae LEE ; Sung Ha HONG ; Hwan Mo LEE ; Seong Hwan MOON
Asian Spine Journal 2014;8(5):653-658
STUDY DESIGN: A case-control study. PURPOSE: To examine several dimensions of health-related quality of life (HRQL) in postmenopausal women with osteoporotic vertebral fractures, compared with a control group. OVERVIEW OF LITERATURE: Osteoporotic vertebral fractures are a major cause of morbidity among postmenopausal women. There have been many reports of a decrease in the quality of life in patients with osteoporotic vertebral fractures. However,few reports have analyzed which dimensions contribute to the decline in quality of life. METHODS: One thousand five hundred forty-five postmenopausal women aged 50 years and older from 17 study sites in nationwide hospitals were in enrolled in the study (between April 2008 and January 2009). HRQL was measured using the European Quality of Life 5 Domains (EQ-5D), and visual analogue scale (VAS). RESULTS: The average VAS of the case group was 57.80, and that of the control group was 64.10 (p=0.001). All domains of the EQ-5D score were significantly worse in the case group (p=0.001). Among the case group, the average VAS of the 559 patients (45%) who were operated on was 56.8, and that of the remaining 680 patients (55%) who were treated conservatively was 58.6 (p=0.135). Among the case group, the averages of each EQ-5D domain of the 559 patients (45%) who were operated on were: 1.87 in mobility, 1.81 in self-care, 1.99 in usual activities, 2.11 in pain, and 1.62 in anxiety or depression. Those of the 680 patients (55%) who were treated conservatively were: 1.72 in mobility, 1.60 in self-care, 1.76 in usual activities, 1.98 in pain, and 1.57 in anxiety or depression. Except for the domain of anxiety or depression, scores for the other domains were all significantly worse in the patients who were operated on (p=0.001). CONCLUSIONS: Health related quality of life in the patients with osteoporotic vertebral fractures was significantly worse in both the EQ-5D domains and VAS. Among the osteoporotic vertebral fracture patients, the patients who were operated on had a worse quality of life in EQ-5D.
Anxiety
;
Case-Control Studies
;
Depression
;
Female
;
Humans
;
Quality of Life*
;
Self Care
8.Considerations of Adequate Inspiratory Sevoflurane Concentrations in General Anesthesia for Caesarean Section.
Jong Pil KIM ; Cheol Hun CHOI ; Seong Wook JEONG ; Myung Ha YOON ; Kyung Yeon YOO ; Chang Young JEONG
Korean Journal of Anesthesiology 2005;49(3):343-348
BACKGROUND: In cases that receive inhalation anesthesia for cesarean section, there is a high risk of recall. So the bispectral index (BIS) is useful for measuring the depth of anesthesia. This study was designed to determine optimal inspiratory sevoflurane concentrations and BIS index values during cesarean section. METHODS: We randomized 30 patients scheduled for elective cesarean section to receive inspiratory sevoflurane 1.0 vol% (group 1, n = 10), inspiratory sevoflurane 1.5 vol% (group 2, n = 10), inspiratory sevoflurane 2.0 vol% (group 3, n = 10) in a 50% nitrous oxide oxygen mixture. Each group was assessed for BIS, blood pressure, heart rate, and end tidal sevoflurane concentration at the point of preinduction, skin incision, uterine incision, delivery, and at 1, 2, 3, 5 and 10 minutes after delivery. Responsiveness to verbal commands using the Tunstall isolated forearm technique, was detected throughout the study period. Neonatal effect was assessed using Apgar scores at 1 and 5 minutes. RESULTS: The BIS index was lower in group 3 than in group 1 from the point of delivery (P<0.05) and the BIS index in group 2 was lower than in group 1 from 1 minute after delivery (P<0.05). However blood pressures, heart rates, and Apgar scores were not significantly different among the groups. No awareness was observed any subject. CONCLUSIONS: We found that the use of inspiratory sevoflurane 2.0 vol% (endtidal 1.2 vol%) maintained a BIS index of under 60.
Anesthesia
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Anesthesia, General*
;
Anesthesia, Inhalation
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Blood Pressure
;
Cesarean Section*
;
Female
;
Forearm
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Heart Rate
;
Humans
;
Nitrous Oxide
;
Oxygen
;
Pregnancy
;
Skin
9.Acute Upper Limb Ischemia Suspected to Have Originated from Staphylococcus Epidermidis Native Valve Endocarditis.
Seong Pil JANG ; Jae Hoon CHOI ; Mi Jin YANG ; Hong Je KIM ; Cheol Gu HWANG ; Ji Ha KIM ; Dong Hun HAN
Korean Journal of Medicine 2014;87(1):81-86
We report a case of acute upper limb ischemia suspected to have originated from methicillin-resistant Staphylococcus epidermidis native valve endocarditis in a 57-year-old man who had complained of sudden-onset fever and pain in the right hand. 3D computed tomography of the right upper extremity detected a thrombus occluding the brachial artery. Echocardiography showed a large vegetation on the aortic valve. Thus, we suspected, clinically, brachial artery occlusion by septic emboli originating from a large vegetation of the aortic valve. The patient was treated with intravenous antibiotics for the suspected methicillin-resistant Staphylococcus epidermidis-native valve endocarditis with a combination of percutaneous aspiration thromboembolectomy and selective intra-arterial thrombolysis for acute thromboembolic occlusion in the right upper limb. The large vegetation of the aortic valve resolved without surgery and aortic regurgitation improved. The patient recovered uneventfully with no complications, including septic embolism, over the following 11 months.
Anti-Bacterial Agents
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Aortic Valve
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Aortic Valve Insufficiency
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Brachial Artery
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Echocardiography
;
Embolism
;
Endocarditis*
;
Fever
;
Hand
;
Humans
;
Ischemia*
;
Methicillin Resistance
;
Middle Aged
;
Staphylococcus
;
Staphylococcus epidermidis*
;
Thromboembolism
;
Thrombosis
;
Upper Extremity*
10.The Versatility of Cheek Rotation Flaps.
Kyung Pil KIM ; Ho Seup SIM ; Jun Ho CHOI ; Sam Yong LEE ; Do Hun LEE ; Seong Hwan KIM ; Hong Min KIM ; Jae Ha HWANG ; Kwang Seog KIM
Archives of Craniofacial Surgery 2016;17(4):190-197
BACKGROUND: The cheek rotation flap has sufficient blood flow and large flap size and it is also flexible and easy to manipulate. It has been used for reconstruction of defects on cheek, lower eyelid, or medial and lateral canthus. For the large defects on central nose, paramedian forehead flap has been used, but patients were reluctant despite the remaining same skin tone on damaged area because of remaining scars on forehead. However, the cheek flap is cosmetically superior as it uses the adjacent large flap. Thus, the study aims to demonstrate its versatility with clinical practices. METHODS: This is retrospective case study on 38 patients who removed facial masses and reconstructed by the cheek rotation flap from 2008 to 2015. It consists of defects on cheek (16), lower eyelid (12), nose (3), medial canthus (3), lateral canthus (2), and preauricle (2). Buccal mucosa was used for the reconstruction of eyelid conjunctiva, and skin graft was processed for nasal mucosa reconstruction. RESULTS: The average defect size was 6.4 cm², and the average flap size was 47.3 cm². Every flap recovered without complications such as abnormal slant, entropion or ectropion in lower eyelid, but revision surgery required in three cases of nasal side wall reconstruction due to the occurrence of dog ear on nasolabial sulcus. CONCLUSION: The cheek rotation flap can be applicable instead of paramedian forehead flap for the large nasal sidewall defect reconstruction as well as former medial and lateral canthal defect reconstruction.
Animals
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Cheek*
;
Cicatrix
;
Conjunctiva
;
Dogs
;
Ear
;
Ectropion
;
Entropion
;
Eyelids
;
Forehead
;
Humans
;
Lacrimal Apparatus
;
Mouth Mucosa
;
Nasal Mucosa
;
Nose
;
Retrospective Studies
;
Skin
;
Skin Pigmentation
;
Transplants